Current surgical educational curricula are composed almost exclusively of apprenticeship style education, and lectures. With a recent mandated decrease in residency work hours, and no decrease in the number and content of the lectures, there is effectively a decrease in the apprenticeship program, thus a decrease in the amount of training, and possibly then, the quality of the final product of training—a general surgeon.
The present invention serves to address this deficiency by generally providing a method and system for use in training and performance programs that involve complex tasks (e.g., medical, aerospace, and aviation training and performance programs) that provide timely performance evaluations to students or trainees. In one contemplated embodiment of the present invention, the method and system is used in surgical training programs to provide near immediate feedback to surgical residents on their operative skills and overall operative performance after each resident-assisted surgical procedure, thereby enhancing resident education, improving the quality of patient care during the resident education process, and making utilization of the operating room training environment more efficient.
The Internal Medicine residency training program at NYU School of Medicine recently implemented a web-based evaluation system, which attempts to address a related problem concerning residency training. This web-based evaluation system is directed toward the following core areas of residency assessment: Clinical Interviewing, Physical Examination, Oral Case Presentations, Differential Diagnosis, Interpretation of Data, Diagnostic Plans, Therapeutic Plans, Teaching Skills, Procedures, and Professionalism. Modules containing evaluation questions are built into the system, with the system reportedly automatically building an appropriate evaluation form from the available modules, on-the-fly, based on the level of training of the evaluator and the resident and the type of assessment. More specifically, after logging into the system, an evaluator selects a resident to evaluate. The system, which is reportedly aware of the training level of both of these individuals, presents the evaluator with a filtered list of evaluation forms that are appropriate to their relationship. The evaluator selects and completes a form, the module-based data is collected and pooled for analysis and summary, and the analysis and summary made available to the resident. This web-based evaluation system, however, does not address, nor serve to provide, among other things, timely operative performance evaluations to surgical trainees or residents and their educators.
The present invention, which also serves to address the deficiency of the above-referenced web-based evaluation system, generally provides a computer-based method for providing timely complex task skills or performance evaluations to students or trainees, the method comprising:
(a) providing at least one computer station operable by trained educators for inputting their evaluations of the complex task performance of trainees and further operable by the trainees, as well as, the trained educators and other educators, for viewing the inputted evaluations;
(b) further providing at least one computer and at least one computer database accessible by the computer(s) for storing information including the trained educator evaluations, wherein the computer comprises memory means and one or more computer programs stored therein suitable for the management and manipulation of the information that is directed into or out of the computer database and/or stored therein;
(c) arranging for the trainees to perform complex tasks under a trained educator's direct supervision;
(d) evaluating each trainee's complex task performance and upon completion of each such task, entering the trained educator's evaluation of the trainee's performance at the computer station and storing the evaluation in the computer database such that the evaluation is accessible by the trainee;
(e) for each such trainee, generating and displaying reports showing the trainee's complex task performance trends over time; and optionally,
(f) for each group or team of such trainees, generating and displaying reports showing the trainee group or team's complex task performance trends over time.
In a preferred embodiment, the inventive method further comprises: providing a communications link between the computer(s) and one or more simulation tools or devices used by the trainees; arranging for trainees to use the one or more simulation devices; importing results from the one or more simulation devices used by the trainees into the computer(s) and storing same in the computer database(s), such that the results are accessible by the trainees, the trained educators and other educators; and using the results from the one or more simulation devices to guide trainee education and training.
In a more preferred embodiment, the inventive computer-based method provides timely skills or performance evaluations to health care practitioners. In this more preferred embodiment, the inventive method may optionally integrate both clinical and simulated clinical performance evaluations.
In yet a more preferred embodiment, the inventive computer-based method provides both timely clinical operative and simulated clinical operative performance evaluations to surgical residents. In this more preferred embodiment, the inventive method may further serve to reduce the risk of human error in the operating room by verifying the identity of a patient and scheduled surgical procedure to be performed on that patient and to provide, among other things, operating room efficiency and safety assessments, in addition to, providing timely surgical resident operative performance evaluations. More specifically, the inventive method may further comprise:
(a) providing a communications link between the computer(s) and a hospital database containing patient information; and for each surgical procedure scheduled to be performed in an operating room,
(b) entering into the computer station a patient identifier which identifies the patient on which the scheduled surgical procedure is to be performed; and if the patient identifier entered into the computer station matches an identifier for that patient stored in the hospital database,
(c) checking the scheduled surgical procedure against the surgical procedure for that patient that is stored in the hospital database; and if the scheduled surgical procedure for the patient matches the surgical procedure for that patient stored in the hospital database,
(d) performing the surgical procedure on the patient; and optionally, for each patient on which a resident-assisted surgical procedure has been performed in the operating room, and using the patient identifier,
(e) collecting from the hospital database clinical parameters such as operating room time, case cost, length of stay, complications, and the like, storing this information in the computer database, and generating and displaying reports assessing, among other things, the operating room's efficiency and safety which are accessible by appropriate hospital personnel.
The present invention further generally provides a system for use in complex task training and performance programs that provides timely skills or performance evaluations to students or trainees, which system comprises:
(a) at least one computer station operable by trained educators for inputting their evaluations of the complex task performance of trainees and further operable by the trainees, as well as, the trained educators and other educators, for viewing the inputted evaluations; and
(b) at least one computer and a computer database accessible by the computer for storing information including trained educator evaluations, wherein the computer comprises memory means and one or more computer programs stored therein suitable for the management and manipulation of the information that is directed into or out of the computer database and/or stored therein.
In a preferred embodiment, the inventive system further comprises: one or more complex task simulation devices; and a communications link between the computer(s) and the one or more simulation devices.
In a more preferred embodiment, the inventive system is used for providing timely skills or performance evaluations to health care practitioners. In this more preferred embodiment, the inventive system may optionally further comprise one or more simulation devices and a communications link between the computer(s) and the one or more simulation devices.
In yet a more preferred embodiment, the inventive system is used for providing both timely clinical operative and simulated clinical operative performance evaluations to surgical residents. In this more preferred embodiment, the inventive system may also aid in reducing the risk of human error in the operating room by verifying the identity of a patient and scheduled surgical procedure to be performed on that patient, and hence provide, among other things, operating room efficiency and safety assessments, in addition to, timely surgical resident operative performance evaluations, and therefore may further comprise a communications link between the computer(s) and a hospital database containing patient information.
Other features and advantages of the invention will be apparent to one of ordinary skill from the following detailed description and drawings. Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. All publications, patent applications, patents and other references mentioned herein are incorporated by reference in their entirety. In case of conflict, the present specification, including definitions, will control.